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DEPARTNNIENNT OF BUILDING AND SAFETY PLUMBING
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COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
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PLUMBER 11 Z r R EIV REA OR DA E ISSUED
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TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O SOLAWS REGULATING PLUMBING
ERTIFY TH T 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 050 n COU CENSE, OR I AM THE LEGAL OWNER RESIDE PROPERTY DESPRIBED ABOVE.
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TGA667 17 B aS® APPLICATION FOR PERBUT
DEPARTbIENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZO E PERMIT NO
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NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
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BATH TUB @ O SO CITY TEL NO
SHOWER O SO 1 HERE ACKNOWLE GB THAT 1 HAVE READ THIS
LAVATORY WASH BASIN O SO APPLICAT10 AND STATB THAT THE ABOVE RS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O SO STATE LAWS REGULJITING PLUMBING
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CERTIFY THAT I POSSESS THE ABOVE VAD LOS
LAUNDRY TUB OR TRAY 050 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDE PRO ERTY ESCRIBBD ABOV&
' GAS SYSTEM-'J—OUTLETS im O SO SIGNATURE OF
WATER HEATER a 060 PERMITT6
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DISHWASHER O SO
DRINKING FOUNTAIN o SO
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HOUSESEWER 050 Z`
MISCELLANEOUS
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DATE INSPECTOR S NAME
ROUGH PLUMBING / C
GAS PIPINGR, 477
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GAS VENT
CESSPOOL too CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) 100 SEWER
PERMIT too GAS TEST
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TOTAL FEE li p
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 LUMBING PE MIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 1
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID –SUILDING
TR 15862 LT 19 A-VINE
FEE DESCRIPTION QUANTITY UOM AMOUNT 2728
ASSESSOR BER NEAREST CROSS STREET BALDWIN
8586 027 019 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1 00 FIX 16 20
TENANT 11 CLOTHESWASHER(S) 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
25 LAVATORIES/SINKS 2 00 FIX 32 40 09/23/99 VG 03 21/00
45 WATER CLOSET/URINAL 1 00 FIX 16 20
OWNER TEL NO 47 WATER HEATER(S)o— 1 00 WTH 16 20 FINAL DATE FINAL CODE
CHUNG LONNIE (626) 688 0425 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 �� f /_��
10219 NADINE ST By
TOTAL FEES 141 15
TEMPLE CITY 91780 r
PLUMBING FOR REMODEL
APPLICANT TEL NO
SAME AS OWNER
SPECIAL CONDITIONS
CONTRACTOR TEL NOS P�(,ELES CO
APPROVALS DATE INSPECTOR SIGNATURE--
SAME AS OWNER
LIC NO UNDER SLAB WORK
WATER SERVICE
f PLASTIC Y/N METAL Y/N
ARCHITECT TEL NO ROUGH PLUMBINr—
L1C NO// GAS PIPING
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REPORT ID DPR263 ROUTE TO BS0508